| Theme | Unraveling of the Pathophysiology of Functional Gastrointestinal Disorders and Updated Treatments | |
|---|---|---|
| Title | The Guideline of Irritable Bowel Syndrome from the View Point of the Differences from the Rome III Definition | |
| Publish Date | 2015/02 | |
| Author | Toshimi Chiba | Division of Gastroenterology, Department of Internal Medi- cine, School of Medicine, Iwate Medical University |
| Author | Takayuki Matsumoto | Division of Gastroenterology, Department of Internal Medi- cine, School of Medicine, Iwate Medical University |
| [ Summary ] | Definition and Epidemiology : Irritable bowel syndrome (IBS) comprises a group of functional bowel disorders, in which abdominal pain and discomfort are associated with defecation disorders and bowel habbits. The prevalence of IBS is higher for women than men. It decreases with age and there are variables associated with geographic areas and socio‒economic status. Pathophysiology : Stress, microbiota, mucosal inflammation, neurotransmitters, endocrine substances, psychological disturbances and genetics are closely related to the pathophysiology of IBS. Diagnosis : The Rome III criteria are useful for the diagnosis of IBS. Functional examinations of gastrointestinal motility reveal obvious differences in the test results between IBS patients and healthy control groups. Treatment : The primary aim of therapy for IBS is to achieve improvements in symptoms. These improvements should be assessed by patients' reported outcomes. Patients with moderately severe symptoms, who do not respond to gut targeted pharmacotherapy, are candidates for second stage treatment. Patients with severe symptoms, who do not respond to traditional pharmacotherapy, should be referred to third stage psychosomatic intervention. Prognosis and complications : IBS is frequently associated with functional dyspepsia (FD) and gastroesophageal reflux disease (GERD). Patients with IBS exhibit extra‒intestinal disorders. Furthermore, patients with inflammatory bowel disease are at higher risk of developing IBS, while the risk of IBD is also high in patients with IBS. Accompanying disorders are closely associated with quality of life for IBS patients. |
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